Crisis Checklist

Inspired by work people have done on madness maps and mental health first aid kits, I decided to make a checklist/flowchart to use when I am having a particularly hard time or am in crisis. It was a good process for me to make because it helped me to really think about what has helped me or caused me trouble in the past. I really like that we can make these sorts of tools for ourselves instead of relying on more general (often judgmental) dos and don’ts or advice from people who never know us as well as we know ourselves.

It also feels comforting to me to make lists sometimes–it can make hard things feel more concrete and manageable to me. At the same time, it hasn’t worked for me wonderfully, in part because I have felt some self-imposed pressure to go through each item even on the list even if it doesn’t feel right to me at the time–it is hard when I am in crisis to figure out whether I should skip to something that feels better or trust the instructions I made for myself when I was in a better state, so I sometimes just stop using the tool altogether.

Also, it is still a little too general for me. I think I might go back to it and try to split it up for different types of crisis–at least based on whether what seems to be most present for me is depression, anxiety, insomnia, or something else. I wanted to share it as an example of a tool I have tried for myself, it case it inspires other people to create or share their own tools. I’m definitely not offering it as a model, since as I said a lot of the value I’ve found is making it very tailored to what I think makes sense for me specifically and even so it hasn’t been as useful as I would like.

Mental Health Crisis Checklist for Gabriel

Have you gotten your hormone shot on time?
If not, do what you need to get it.

Have you had a meal within the last 5 hours or are you hungry?
If no to former or yes to latter, eat.

Have you taken your meds/supplements?
If not, do what you need to take them.

Have you recently changed psych meds OR do you think your psych meds are wrong for you?
If yes to either, call psych.

Do you have any unusual medical symptoms, do you think you might have an unaddressed physical injury or illness, or are you behind on any regular checkups?
If so, call your doctor.

Have you been playing a game that you aren’t even enjoying for hours on end?
If so, stop.

Are you feeling really emotionally vulnerable and considering having sex with a stranger?
If so, don’t do it today.

Have you showered today?
If not, take a shower.

What is the thing you have not done that is stressing you out the most?
Do that thing.

Are you actively upset about something specific?
If so, tell someone about it (if you haven’t already), then give yourself 10-20 minutes to write about it, then 5-10 minutes to just breathe and feel what you’re feeling about it, and then let it go for today.

Are people counting on you to get something done today?
If so, do it or arrange for whatever leeway you need.

Are you feeling isolated, lonely, misanthropic, strongly tempted to withdraw, or actively afraid for yourself?
If yes to ANY, call and/or write at least three friends, lovers, and/or relatives. If actively afraid for yourself, also call therapist. Then, read Icarus Project boards and/or QMH. (Editor’s note: Glad we could help! And thanks for the nod.)

Is it warm and sunny outside?
If yes, go sit in the sun.

Are you feeling out of touch with your body, restless, or listless AND have you not done anything to get in touch with your body today?
If yes to both, get a massage, walk up a lot of stairs, go to a yoga class, use an elliptical machine, have sex, or do SM.

Do you have gaming or other social plans tonight?
If so, keep them.

Do you have social plans for later this week?
If not, make some.

Do you have therapy scheduled for this week?
If so, keep the appointment; if not, make an appointment.

Have you given yourself enough time to sleep at night?
If not, cancel or rearrange whatever you need to give yourself 10 hours to sleep tonight and tomorrow night. Also, take a nap if you are really tired/sleep deprived.

Is it the middle of the night and you are sleepless and miserable?
If so, follow these steps until you’re asleep or at the end of the list.
1. If you need to go to the bathroom, go.
2. If it would be safe and possible for you to take (another) sleeping pill, take it.
3. If you keep thinking of things you need to do, make a list of them.
4. If 1, 2 and/or 3 applied, give yourself another 30 min to get to sleep.
5. If your sleeping environment is uncomfortable or unfamiliar in any way you can change, change it.
6. If 5 applied, give yourself another 20 min to get to sleep.
7. Make yourself a cup of tea.
8. If you’re hungry, eat a snack.
9. If you’re in pain, take a pain killer.
10. Call someone, watch a movie, read a book, or play a video game for up to 2 hours.
11. Give yourself another 30 min to get to sleep.
12. Listen to some chilled out music or a guided meditation.
13. Just lay in bed and breathe deeply, to give your body a chance to rest, for an hour or longer if it’s still feeling good.
14. Start your day.

Is your hair length bothering you?
If so, get a hair cut.

Do you need comfort?
If so, play with your cats or find another furry animal to play with.

Is there a project you are excited about working on?
If so, spend some time working on it.

Do you think you might be able to perceive beauty?
If so, go out of your way to experience it. Listen to music, take a walk in a park, go to a museum.

Do you need to chill out/come down/tune out for a while?
If so, choose the most appealing and calming game you have access to and play it for up to 2 hours.

Do you feel you are experiencing a crisis that is particularly serious OR has gone on for more than three days (or more than three weeks since the last time you added/changed something below)?
If so, choose one from the list to add (or change) in your routine and do what you need to make it happen:

Is the degree of mess in your apartment actively bothering you?
If so, EITHER pick the top two tasks that need to get done and do them OR spend 15 minutes doing general organization/tidying.

Do you think you might really, imminently, physically harm yourself or someone else?
If so, call two friends and tell them. If you don’t get through to them, call two more. Get one of them to come with you to walk-in counseling, an urgent mental health care clinic, or a hospital emergency room and ask the other to be on-call to support, let your other closest support people know, and/or take care of any urgent logistics. Then go.

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By Kelsey MacKenzie

Wow, this is a really thorough list! Sometimes when we’re feeling really absorbed in our crisis, it’s great to have a list of logical advice that might otherwise evade us in our distress. I actually really love this idea, I might just consider doing this for myself! Thanks for sharing!